| NPI | 1073523379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WALTER BALLRICK President 440-331-5450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: OH 30.022156) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-09-07 |